Critical Patient Monitoring & CPR Flashcards
A Swan–Ganz catheter is used to measure which parameter
Pulmonary artery occlusion pressure
A “shark-fin” appearance to a capnography would indicate which abnormality
Airway or breathing circuit obstruction
A right-shifted oxyhemoglobin dissociation curve could be the result of which phenomenon
Acidemia
Absence of lung sounds in a lung field can be an indicator of which pathology
Pneumothorax (dorsal lung field), Pleural space disease (ventral lung fields), lung consolidation from pneumonia or atelectasis (focal lung dullness)
The most accurate monitor for veterinary patients is
Experienced and trained veterinary technician
When interpreting an arterial blood pressure wave, which of the following findings may indicate vasoconstriction in the patient
The dicrotic notch is high and approaches the systolic pressure
In a patient suffering from head trauma and increased intracranial pressure, which of the following can directly contribute to worsening intracranial pressure
Hypercapnia
Cardiac output is the product of
HR x SV
Under normal circumstances, a patient that has an EtCO2 of 40^mmHg is expected to have a PaCO2 of approximately
42-47mmHg
Hypocapnia can commonly be caused by
Decreased cardiac output
Pulse Pressure
Difference between systolic and diastolic pressure
What can crackles be an indicator of?
Pulmonary edema, fluid overload, CHF, pulmonary fibrosis
What can be a subtle indication of rising ICP?
changes to mentation,
pupillary light reflex, RR and pattern
Increase in BP with a decrease in HR (Cushing’s reflex)
What is normal urinary output?
1-2 mL/kg/hr not on IVF
Arterial Blood Pressure Waveform
1 - systolic upstroke (anacrotic limb) –> ventricular ejection of blood into systemic arterial system (can be slurred or prolonged in aortic outflow obstruction.
2 - top of waveform is peak systolic blood pressure (maximum pressure generated during ventricular ejection)
3 - rapid decline (dicrotic limb) ventricular contraction comes to and end (aortic valve closure)
4 - descend until lowest point –> diastolic pressure
Under wave - MAP
Overdamping
Moves away from aorta and more peripheral.
Air bubbles in tubing, blood clot in catheter, connection tubing is too compliant (not stiff enough)
SBP –> lower
DBP –> higher
Dull rounded appearance
Underdamping
SBP –> higher
DBP –> Lower
Tall and sharp appearance
Doppler shift
Frequency change in sound waves (doppler when sound returns)
Dopplers in cats
Known to underestimate - add ~14mmHg
(more closely related to the MAP)
Non invasive BP cuffs
40-60% of circumference
too small - falsely elevate
too big - minimal effect
Oxygenation - hemoglobin curve (right shift)
oxygen has less affinity with hemoglobin and allows for greater tissue oxygen unloading
(Elevations in body temp, acidemia, hypercapnia, upregulation of 2,3 DPG, anemia)
CADET - FACE RIGHT
C - CO2 INCREASE
A - ACIDEMIA & ANEMIA
D - 2,3 DPG
E - EXERCISE
T - TEMPURATURE INCREASED
Left shift of oxygenation - hemoglobin curve
Oxygen has more affinity with hemoglobin and allows for less tissue oxygen unloading
(Decreased in temp, alkalosis, CO poisoning, hypocapnia)
Normal EtCO2
35-45mmHg
cats 30-35mmHg
Hypercapnia
Hypoventilation, rebreathing of CO2, increased CO2 production
